NHS Long-Term Plan

Debate between Jeremy Hunt and Nicholas Dakin

Monday 18th June 2018 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right, and that is a big priority for us, which is why this year we will publish a final 10-year NHS workforce plan, at the same time as the NHS plan that Simon Stevens is putting together. Together they are designed precisely to avoid shortages in particular and very important specialties.

[Nic Dakin (Scunthorpe) (Lab)]

Community pharmacies feel stretched at the moment, yet they are well placed, at the heart of the community, to have a real impact by taking pressure off GPs. Will the Secretary of State give a commitment that some of this money will go to reinforce the strength of community pharmacies so that they can play their part in prevention as well as cure?

[Mr Hunt]

The hon. Gentleman is right that community pharmacies have a vital role to play. I do not think we use them enough. We need to find better ways for them to help us in the prevention agenda, and one way we are doing that is by integrating medical records so that they can be accessed by pharmacies, which will help them to give good advice to patients.

Breast Cancer Screening

Debate between Jeremy Hunt and Nicholas Dakin

Wednesday 2nd May 2018 Commons Chamber

[Mr Hunt]

I thank my right hon. Friend for suggesting the Bishop of Norwich as a good person to help in the Paterson review, and the answer to her question is yes: if, because of a failing by the NHS, harm has happened, people will be eligible for compensation, and we will do all the necessary work to establish whether that is the case.

[Nic Dakin (Scunthorpe) (Lab)]

Breast cancer screening makes a real difference to outcomes for breast cancer patients by diagnosing early, so I applaud the Secretary of State for saying he will look at ways of improving performance in this area across the country, but what is he going to do to try to make women who have moved out of the UK who might be affected aware of what has happened?

[Mr Hunt]

We will look at whether we are able to get in contact with people and will get in contact whenever we can, but there is of course a helpline through which anyone can contact us. It is also important to say that, according to the advice I have received, missing the final screening will in many cases not make a difference to a patient’s cancer or the treatment they receive, but we will do everything we can to support everyone who thinks they might have been affected.

Defending Public Services

Debate between Jeremy Hunt and Nicholas Dakin

Monday 23rd May 2016 Commons Chamber

[Mr Hunt]

We need extra legislation to expedite the process. I point out to my right hon. Friend that that is another policy which has been opposed by the Labour party. All the time it says we should be doing more to get a grip on NHS finances and yet it opposes every policy we put forward in order to do precisely that. The answer to his question is that the issue with the NHS is primarily that we are not very good at collecting the money to which we are entitled from other European countries, because we are not very good at measuring when European citizens are using the NHS. This legislation will help us to put those measurement systems in place so that we can get back what we hope will be about half a billion pounds a year by the end of this Parliament.

We will no doubt hear later this afternoon the charge that the Government have lost control of NHS finances, but we strongly reject that charge. The House may want to ask about the credibility of that accusation from a party that is at the same time proposing a funding cut for the NHS and criticising the difficult decisions we need to take to sort out NHS finances.

[Nic Dakin (Scunthorpe) (Lab)]

Two months into this financial year, can the Secretary of State say whether or not the Department of Health broke its budget for last year?

[Mr Hunt]

We will find out those figures when the full audit is complete. I just say to the hon. Gentleman that efficiency savings are never easy, but a party with the true interests of NHS patients at heart should support those efficiency savings, because every pound saved by avoiding waste is one we can spend improving patient care.

Let me therefore outline to the House what we are doing to deliver those efficiencies, as well as to support NHS trusts to return to financial balance. First, we are taking tough measures to reduce the cost of agency staff, including putting caps on total agency spend and limits on the rates paid to those working for agencies. So far, that has saved £290 million, with the market rate for agency nurses down 10% since October and with two thirds of trusts saying that they have benefited. Our plan is to reduce agency spend by £1.2 billion during this financial year. Secondly, we are introducing centralised procurement under the Carter reforms. Already 92 trusts are sharing, for the first time, information on the top 100 products they purchase in real time, and we expect savings of more than £700 million a year during this Parliament as a result. Thirdly, given that the pay bill is about two thirds of a typical hospital’s costs base, we are supporting trusts to improve on the gross inefficiency of the largely paper-based rostering systems used at present. This should also significantly increase flexibility and the work-life balance for staff, as we announced last week. Finally, and perhaps most critically, we will reduce demand for hospital services by a dramatic transformation of out-of-hospital care, as outlined in the five-year forward view. If we meet our ambitions, we will reduce demand by more than £4 billion a year through prevention, improved GP provision, mental health access and integrated health and social care.

Junior Doctors Contract

Debate between Jeremy Hunt and Nicholas Dakin

Thursday 19th May 2016 Commons Chamber

[Mr Hunt]

Yes, I am happy to do that, and I thank my hon. Friend for a lot of his correspondence. The principle here is that junior doctors want to know that there is someone independent they can appeal to if they think they are being asked to work hours that are unsafe and which mean that they cannot look after patients in the way that they would want to because they are physically or mentally too exhausted. We would all want to make that possible, but it means that they need to have someone who is not their line manager. They will go to their line manager in the first instance, but they need to have someone independent and separate. One area where we have made the most progress during the past few months, even before the past 10 days of talks, is on establishing how these guardians can work in a way that has the trust of both the hospitals and the doctors working in them.

[Nic Dakin (Scunthorpe) (Lab)]

The Secretary of State is absolutely right that we can always get further if we get round the table, so why, in response to the cross-party initiative back in February to get everybody around the table, did he not do exactly that and save us all this trouble, rather than trying to impose the contract?

[Mr Hunt]

The cross-party initiative was not to have a new contract, but to abandon plans for a new contract and to have pilots in a few limited places. If we had followed that advice, we would not now have agreed with the BMA the biggest changes in the junior doctors contract for 17 years. Our goal was to get the agreement that we secured yesterday—safer care for the NHS and a better deal for doctors. That was what we achieved, and we would not have got there if we had listened to that advice.

Junior Doctors Contracts

Debate between Jeremy Hunt and Nicholas Dakin

Monday 25th April 2016 Commons Chamber

[Mr Hunt]

I think many people inside and outside the medical profession are deeply upset that that is happening. I really enjoyed my visit to my hon. Friend’s constituency, and we will continue to invest in his local health services. I think that his constituents will be upset by the fact that the pay and conditions many of them have for working at weekends go nowhere near what is being offered to junior doctors under the new contract. In that sense, it is totally disproportionate to withdraw emergency care, which is such an extreme measure and has never happened before.

[Nic Dakin (Scunthorpe) (Lab)]

I welcome the Secretary of State’s recognition that junior doctors are the backbone of the NHS and his expression of willingness to talk about the implementation of the contract. Those words are great, but I urge him to take actions to match them and take the opportunity of the cross-party initiative to pilot this contract. If he does not do that and ploughs on regardless, he will jeopardise patient safety.

[Mr Hunt]

I welcome any genuine attempt to try to resolve this issue, but Health Education England has said that it does not believe that that cross-party approach is workable. As I have said to the hon. Gentleman before, having pilots of seven-day care and new junior doctor contracts would mean that we took too long to deliver a key manifesto promise.

Junior Doctors Contracts

Debate between Jeremy Hunt and Nicholas Dakin

Monday 18th April 2016 Commons Chamber

[Mr Hunt]

We do have that power by law. The letter we put out in defence against the legal action that has been taken against the Government explains very clearly why and how we have that power. It is all written there for the hon. Gentleman to see. I assure him that, on something as contentious and difficult as this, we take every care to make sure that we are acting within the law.

[Nic Dakin (Scunthorpe) (Lab)]

If I were Secretary of State for Health, I would feel personally responsible for this unprecedented action taking place on my watch, and I would do everything I could to build bridges to make sure it did not happen and that patients were not threatened in the way we all fear. What is the Secretary of State doing to build trust between himself and the NHS workforce?

[Mr Hunt]

I will tell the hon. Gentleman one of the things we are doing, which is turning around the hospital in his own constituency, which is no longer in special measures because the quality of care has improved dramatically. What else are we doing? Over three years, there have been 75 meetings, 73 concessions and three different independent processes. We have tried everything to get a negotiated outcome, but in the end we have to do the thing that is right for patients.

William Mead: 111 Helpline

Debate between Jeremy Hunt and Nicholas Dakin

Tuesday 26th January 2016 Commons Chamber

[Mr Hunt]

I do agree that we need more clinicians in primary care. We also need to invest in secondary care, which is why the hon. Lady has a new A&E centre opening in Hull, which I am sure she welcomes. We need more clinicians in primary care so that we can deal with these issues more quickly, before people need hospital care and to spot conditions such as sepsis. This Government are investing £10 billion in the NHS annually in real terms in order to step up the improvement in the services that we offer.

[Nic Dakin (Scunthorpe) (Lab)]

So will the Secretary of State put a higher proportion of clinicians in 111?

[Mr Hunt]

We will certainly look at whether we need to have more clinicians in 111. We do have clinicians available in 111. My own view is that it is the separation of the out-of-hours services and the 111 service that is at the heart of the problem that we are looking to deal with, but as part of the review we will look at the availability of clinicians in 111.

Five Year Forward View

Debate between Jeremy Hunt and Nicholas Dakin

Thursday 23rd October 2014 Commons Chamber

[Mr Hunt]

Exactly—that is precisely the point. This report has example after example of how the new structures—clinical commissioning groups—are integrating care. That is why it makes it so clear that it would be wrong to do what Labour wants to do, which is to repeal the Health and Social Care Act 2012 and to strip CCGs of their powers when they are providing precisely the integrated care that we all think is important.

[Nic Dakin (Scunthorpe) (Lab)]

Northern Lincolnshire and Goole Hospitals NHS Trust has made significant progress over the past two years, but it remains financially very challenged and in significant deficit. What, if anything, in these plans will help to remedy that challenging situation?

[Mr Hunt]

Two things. I have had a very interesting visit to Goole hospital. It was very impressive to see how it has responded to the special measures programme and how, as a result of the new inspection regime, which Labour Front Benchers tried to vote down, it has made real improvements in care on the front line for the hon. Gentleman’s constituents. Those at the hospital will be pleased to see that this report endorses the new transparent approach to dealing with variations in care. It also says that we need to continue with increases in real-terms funding for the NHS, which we only get with a strong economy.

Special Measures Regime

Debate between Jeremy Hunt and Nicholas Dakin

Wednesday 16th July 2014 Commons Chamber

[Mr Hunt]

That is certainly something we keep under constant review, because it is a particular issue in some trusts. I would like to pay tribute to the progress made in Sherwood Forest trust—and in Newark hospital, which I know my hon. Friend has campaigned for—and to mention that it has an excellent chief executive, who has done a very good job in challenging circumstances.

[Nic Dakin (Scunthorpe) (Lab)]

I would like to pay tribute to the staff team at Northern Lincolnshire and Goole Hospitals Trust for the progress they have made, which has resulted in the trust moving out of special measures, but there is still much more to do. How will the Secretary of State ensure that the funding challenges faced by the local health service do not get in the way of making the further progress that is necessary?

[Mr Hunt]

Good progress has indeed been there, including centralising stroke services in Scunthorpe. There are funding pressures everywhere. What I would say about funding is that I do not want to run away from the fact that money is tight throughout the NHS, but lots of places are delivering safe, compassionate care even with those funding constraints. In fact, when we look in detail, we see that less safe care is the most expensive, so what we are doing should help trusts such as the hon. Gentleman’s to deliver safer care.

Patient Safety

Debate between Jeremy Hunt and Nicholas Dakin

Tuesday 24th June 2014 Commons Chamber

[Mr Hunt]

My hon. Friend speaks wisely, and I commend her for her work in championing whistleblowers. In her relatively brief time here, she has made a big difference on that issue. Personally, I do not like to use the term “naming and shaming” because I think identifying problems should always be the first step to sorting them out. What we are doing today by identifying trusts that do not have a proper open and honest reporting culture is also helping them to change that reporting culture while at the same time identifying trusts that have a good culture. It is all about changing the culture, so this is a positive move, and I think that NHS staff will really welcome it.

[Nic Dakin (Scunthorpe) (Lab)]

Does the Secretary of State agree that the best way to deal with concerns about patient safety, such as those raised last week about Scunthorpe general hospital, is to have a proper independent investigation that respects patient confidentiality and reports objectively, clearly and transparently so that appropriate action can be taken when all the facts are known?

[Mr Hunt]

There are definitely times when an independent investigation is needed, and a number of them are going on in the NHS at the moment. The first thing, however, is to talk to the trust and get it to deal with the particular issues being raised and to create a culture in which trusts are willing, enthusiastic and keen to do that. Today is an attempt to deal not only with what happens when things go wrong with whistleblowers, but with how to create the right culture in the first place.

Urgent and Emergency Care Review

Debate between Jeremy Hunt and Nicholas Dakin

Tuesday 12th November 2013 Commons Chamber

[Mr Hunt]

My hon. Friend speaks extremely wisely. He invited me to visit Kettering hospital, and I saw for myself that it was a very, very busy hospital. In the end, if we just stick with the current model we will reach bursting point, which is why we need to look at new models. That is why tomorrow’s review is important, and part of that—in fact, the bulk of the work in tomorrow’s review—is about how we transform out-of-hospital care, which is the big strategic change that we need to make in our NHS, and on which I am afraid the previous Government made so little progress.

[Nic Dakin (Scunthorpe) (Lab)]

Tomorrow’s review is supposed to deal with issues to do with this winter. Will the Secretary of State give the House an assurance that there will be no crisis of A and E on his watch this winter?

[Mr Hunt]

A and E departments are under huge pressure. We are seeing about 1 million more people every year than three years ago, and we have done more this year than has ever been done in NHS history to help to prepare the NHS for winter, including giving £250 million to 53 local health economies where the pressures are greatest. We continue to monitor the situation very, very closely to give more support where we can.

Accident and Emergency Departments

Debate between Jeremy Hunt and Nicholas Dakin

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

I always try to support the ideas that come up from different parts of the NHS because people on the ground usually have the best ideas about what needs to be done, but when decisions cross my desk it is important that I consider the knock-on effect on other areas, and I get independent advice on that as well. I shall follow closely the proposal that my hon. Friend mentions.

[Nic Dakin (Scunthorpe) (Lab)]

Does the Secretary of State believe that he has done enough to avoid a crisis in A and E this winter?

[Mr Hunt]

I think we have done everything we can, and we have tried to listen hard to the suggestions for what can help in the short term and what can address the underlying problems. I believe it is possible for the NHS to meet its targets this winter, but I do not want to say that it is going to be easy. It will be a very tough winter and we need to get behind the doctors and nurses on the front line who are doing their very best to deliver a great service to the public.

Hospital Mortality Rates

Debate between Jeremy Hunt and Nicholas Dakin

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

My hon. Friend makes a very important point. The simple way we can change that culture, which will not be easy and will not happen immediately, is by making sure that where there is failure, there is someone who is independent and able to speak up about that failure without fear or favour—someone to be the nation’s whistleblower-in-chief. That is what we must have with the new chief inspector of hospitals, modelled on the chief inspector of schools and how well the whole Ofsted regulation system has worked. That has to be the first step; there must be no hiding place when there is failure. From there, we will have the pressure on the whole system, right the way up to Ministers, to make sure that failure is sorted out.

[Nic Dakin (Scunthorpe) (Lab)]

Sir Bruce Keogh warns us in his report about the very reaction we have seen today, which is in danger of shaming this House by focusing on politics instead of people. He wrote in his first few paragraphs that

“this is not a time for hasty reactions and recriminations”.

I read those words at five past 8 this morning when the Department of Health finally opened up to allow Members of Parliament to read what was there. Will the Secretary of State assure me and my constituents, who use Scunthorpe general hospital, that he will work to support people and put people before politics, because this afternoon he has put politics before people?

[Mr Hunt]

That is exactly what I am doing; the best hope we can give to the hon. Gentleman’s constituents is to say that we are putting them first by being honest about the problems and by tackling the mediocrity that has been a feature of too many hospitals for too long.

Children’s Heart Surgery

Debate between Jeremy Hunt and Nicholas Dakin

Wednesday 12th June 2013 Commons Chamber

[Mr Hunt]

I do not want to pluck a number out of the air; I want to listen to the clinical evidence on that. However, it is important to say that as a result of the excess mortality identified at Bristol the Kennedy report said that up to 170 lives could have been saved over a 10-year period in just one location. That is why it is so important that we get this decision right.

[Nic Dakin (Scunthorpe) (Lab)]

The Secretary of State is right to say that, sadly, the process did not have the confidence of the public. I very much welcome his statement. In moving forward, will he ensure that any data used are independent, transparent and credible, and that patient experience and access are given the right priority in the decision making?

[Mr Hunt]

Those are all things that the IRP talked about in its review, and I very much accept its recommendations in those areas.

Heart Surgery (Leeds)

Debate between Jeremy Hunt and Nicholas Dakin

Monday 15th April 2013 Commons Chamber

[Mr Hunt]

There are some risks, of course, in suspending surgery, but when we have mortality data such as those that Professor Sir Bruce Keogh was faced with, there are also considerable risks involved in doing nothing in response. The decision was taken not to close the children’s heart unit but to suspend surgery until he could get to the bottom of whether there was any truth in the data. He had a very difficult decision to make, given that situation, but I think he made the right decision.

[Nic Dakin (Scunthorpe) (Lab)]

Parents of very poorly children in the Scunthorpe area who have been very effectively supported by the Leeds unit have been dismayed to hear what has been happening over the past month or so. The Secretary of State has given us clear answers this afternoon, and I thank him for that. He has said that there will be a resolution to the Safe and Sustainable review as soon as possible. Will that be in 2013 or at some point beyond that?

[Mr Hunt]

I very much hope that this does not go beyond 2013, but I am afraid that that is not in my hands, because of legal due process. Legal proceedings are under way at the moment and I have to consider the advice of the Independent Reconfiguration Panel, but I want to stress to the hon. Gentleman, as I have to many hon. Members, my determination to resolve the situation as quickly as possible.